SAN DIEGO — Retired Lt. Mark Donald, a veteran Navy SEAL, escaped death multiple times but saw friends fall in battle and, as a combat medic, watched men die in his arms as he tried to save them.

But in the safety and comfort of home, Donald found himself adrift, even after the military awarded him the Navy Cross, the nation's second-highest medal for combat valor, stemming from a deadly 2003 battle in Afghanistan.

In combat, Donald controlled his emotions, suppressed his feelings and reacted just as he was trained.

"The demons that haunted my sleep retreated into the darkness of my psyche," he wrote in "Battle Ready: Memoir of a SEAL Warrior Medic," which will be released March 12.

But stateside, his mind remained over there and home became uncomfortable, so he returned to the combat zone.

"The whirlwind of adrenaline, anger and fear related to combat had become a drug," he wrote.

Along the way, he boxed up his emotions in the war chest in his mind, which at times exploded from self-criticism of missions unfulfilled; an early, broken first marriage and career-necessitated separations in his second; fallen comrades; or whatever weighed heaviest at the moment.

He shunned others and often burst out in anger as he battled doubts and deep depression. It took him several years, he said, to realize the impact of his behavior on others, including his wife and daughter, which led to counseling and help that continues today.

The Navy Cross, awarded privately, later went public; people try to reconcile the image depicted in the award citation with you, he said in an interview, but often "all that pressure comes tumbling down."

Hitting bottom

The former Marine-turned-SEAL is not alone in battling the psychological and physical injuries of war Donald likens to a "sustained stress syndrome" that can lead to depression, isolation, violence and even suicide. Multiple combat deployments, high operationals tempo and long or repeated family separations are common after a dozen years of war, especially in the Navy's special warfare community that remains heavily in demand.

One might think that Donald — a motivational speaker whose decorations also include the Silver Star and Bronze Star with "V" — would be among the last to suffer the strains of combat stress.

But Donald battled depression, and at times his mind filled with irrational thoughts. "I was still trying to keep my Jekyll and Hyde temperament hidden from my own family," he wrote. "One moment I'm loving and joking, and the next I might be broodingly angry or locking myself away."

When sleep escaped him, he wrote, he turned to vodka and "anything in the medicine cabinet that would help me sleep through the night." During the day, he'd stare at photographs on his walls. "I was self-destructing, and I knew it," he wrote, adding, "I felt alone and scared of what I might do."

But one day, after finishing a bottle of vodka, he walked into his bedroom and spotted a weapon case under the bed. He's not sure why, but he grabbed it and walked back to the living room and unlocked it. "Without even thinking, I had a pistol in my hand and had pushed a magazine through its handle," he wrote. "Like so many times before, I felt as if I was watching myself from across the room.

"I had no emotion whatsoever. I was indifferent to everything around me, all I knew was I needed help before I hurt someone."

That's when the phone rang. It was his mother.

A religious woman who had worked three jobs to care for three children, Donald's Mexican-born mother provided him the emotional and moral support he needed. "When things get too much, like they are for you now, I ask for help," she told him. "You know people want to help, you just have to let them know how." She added: "It's time to swallow our pride, mijo, and accept some help."

Donald eventually did and found journal therapy as a means of sorting his thoughts, a project that eventually led to his memoir. Word of his nomination for the Navy Cross triggered new fears, notably of failing to live up to what the valor medal represents. But his mother's stories about burdens and reassuring words — "sometimes we have to lose everything in order to realize what we really have" — helped restore his faith and confront his demons with professional help and fellow veterans.

"I was slowly learning how to live with the stressors caused by combat," he wrote, "and not suffer from them."